12 MONTH SMILES LLC
NPI: 1033541073
· FAIRFIELD, CT 06825
· General Practice Dentistry
· NPI assigned 08/01/2013
$498.20
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: ARORA, TARVINDER PAL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
27 |
$498.20 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
13 |
12 |
$280.70 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
12 |
$217.50 |